Growing Gap in Life Expectancies Of Blacks and Whites Is Emerging

By PHILIP J. HILTS, Special to The New York Times

Published: October 9, 1989

WASHINGTON, Oct. 8—
After narrowing for decades, the gap in life expectancy between blacks and whites has grown for three years in a row, Federal health experts say, and most of the disparity is due to patterns of behavior.

The experts said the trend has been caused almost entirely by deaths from causes like AIDS, drug abuse, alcoholism and car accidents, and not by diseases that are much less subject to control.

In fact, for the three leading causes of death - cancer, heart disease and stroke - the new statistics show that improvement among blacks has been as good as or better than that among whites, said Dr. Harry M. Rosenberg, chief of the mortality statistics branch of the National Center for Health Statistics.

But from 1984 to 1987, the gap between the races increased from 5.6 years to 6.2 years, Dr. Rosenberg said. A white child born in 1987, the latest year for which the data have been analyzed, could expect to live about 75.6 years, Federal figures released last week show. A black child could expect a life of 69.4 years. A Good Overall Measure

Life expectancy statistics are a good measure of both overall health and death rates because they are taken from a complete count and analysis of all the approximately two million death certificates filed each year in the United States.

The causes of death that increased much more for blacks than for whites and were the chief factors in the widening gap, were, in order: AIDS; drug overdoses and other drug-related factors; diseases and disabilities that kill infants in their first year; accidents, chiefly those involving motor vehicles, and chronic liver disease including cirrhosis caused by alcoholism.

Dr. Christine Hale, an expert in mortality statistics at the University of Washington, said, ''The trend is appalling. And there is one thing all these causes have in common: they are preventable. This is essentially self-destructive behavior, and it is a pattern you get when people are despairing.''

Since the statistics were first compiled in 1900, there has been a gap between the races, but it had narrowed from 14.6 years in 1900 to 5.6 years in 1984. A Change in 1984

Then in 1984, for the first time, the life expectancy for blacks began to fall while it continued to rise for whites. The difference was noted, but statisticians were uncertain of its causes.

In the latest report, the National Center for Health Statistics said the gap had continued to widen for a third year. In addition, Dr, Rosenberg said, two major trends are expected to worsen considerably, the number of AIDS deaths and homicides among young black men.

As medicine and public health practices improved, the life expectancy for both races had improved. Life expectancy sometimes fell, like during outbreaks of influenza, but until now the figures for both races dropped and rebounded together.

Life expectancy at birth is a statistical measure that represents the average number of years infants would live if they were to experience the death rates that prevail for different age groups in the year they were born. Trend Is 'Ominous'

''The numbers themselves don't seem large yet, but the direction is so ominous that it is of great concern,'' said Dr. William P. O'Hare, director of policy studies at the Population Reference Bureau, a research center here. ''The Government and society should be concerned about these numbers, because it means the loss of many productive workers and taxpayers.

''I suspect that the mortality rate is also an indicator of something else. In addition to the people dying, there are other ones who are disabled and become a burden to society and the health care system from the same causes. We have to pay to take care of them as well as losing their capacity to work.''

Dr. William Julius Wilson, a sociologist at the University of Chicago and the president of the American Sociological Association, said the ''disturbing decreases in life expectancy correspond with recent increases in the black poverty rate and, more important, increases in the severity of black poverty.''

He noted that in 1978 one third of poor blacks had an income of less than $5,000 a year, when the Government designates a family of three as poor if its annual income is less than $10,000. By 1987, Dr. Wilson said, nearly half of poor blacks had fallen below the $5,000 level. Decreases in Social Programs

Dr. Wilson also cited large decreases in social programs as possibly contributing to the widening gap in mortality rates. The total appropriations for programs like subsidized housing, health services, social services and job training fell by 54 percent from 1981 to 1988, he said, and programs like food stamps and aid to families with dependent children were also cut substantially.

Earnings of black workers have also declined, Dr. Wilson said. The median earnings of young black workers who head families have dropped by one half from 1973 to 1986, after being adjusted for inflation, he said.

''It is hard for me to believe that these factors are not related to the decline in life expectancy,'' Dr. Wilson said. ''People with less income cannot get the kind of medical care others do. People without jobs or money resort to drug use as they try to deal with their frustrations.'' A Question of Policy Choices

Dr. Herbert Nickens, the director of the division of minority health at the American Association of Medical Colleges, said the main question now is, ''What policy choices should be made in the face of these numbers?''

''We don't have a vaccine for homicide,'' he said. ''But on drug-related deaths we ought to open more drug treatment facilities. We should not have people on waiting lists for treatment.

''Most people have a sense that things are spinning out of control. There is a bleak outlook and a locked-in quality to these conditions. No one since Lyndon Johnson has stood up and said, 'We're going to fix this.' We simply have not had a national resolve.''

Another main element in the widening gap has been infant mortality. The disparity in infant mortality between blacks and whites has widened since the late 1970's, said Kay Johnson, director of the health division for the Children's Defense Fund.

The infant mortality rate for blacks was 1.78 times that for whites in 1973, she said. But by 1987 it had risen to 2.07 times the white rate.

''Progress has just stopped,'' Ms. Johnson said.

Graph of life expectancy between whites and blacks from '84-'87 (source: National Center for Health Statistics) (NYT)